Prevalence and comparative characteristics of long-term nonprogressors and HIV controller patients in the French Hospital Database on HIV

Objective: To estimate the prevalence and characteristics of long-term nonprogressor (LTNP) and HIV controller patients in a very large French cohort of HIV1-infected patients. Methods: In the French Hospital Database on HIV [FHDH, Agence Nationale de Recherches sur le SIDA et les hepatites virales (ANRS) CO4], we selected patients who had been seen in 2005, who had been infected for more than 8 years, who were treatment-naive, and who remained asymptomatic. Patients with these characteristics then categorized as follows: LTNP (>= 8 years of HIV infection and CD4 cell nadir >= 500/mu l), elite LTNP (>= 8 years of HIV infection, CD4 cell nadir >= 600/mu l, and a positive CD4 slope), HIV controllers (>10 years of HIV infection with 90% of plasma viral load values <= 500 copies/ml), and elite controllers (same as HIV controllers, but with last plasma viral load value <= 50 copies/ml in 2005). Results: Among the 46880 HIV1-infected patients followed in 2005 in the French Hospital Database on HIV, 0.41% (N=202) were LTNP, 0.05% (N=25) were elite LTNP, 0.22% (N=101) were HIV controllers, and 0.15% (N=69) were elite controllers. Ten elite LTNP patients (40%) were also HIV controllers, eight (32%) were elite controllers, and 60% had detectable plasma viral load (>50 copies/ml). Among the elite controllers, 32 (46%) were LTNP, eight (12%) were elite LTNP, and one-quarter had a last CD4 cell count less than 500/mu l. Conclusion: LTNP, elite LTNP, HIV controller, and elite controller patients are rare phenotypes. Elite LTNP patients are less frequent than HIV controllers. There is little overlap among the four subgroups of patients. (C) 2009 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins